Nipping cervical cancer in the bud

Zimbabwe has waged a war against cervical cancer at a national scale through administration of the human papilloma virus (HPV) vaccine to girls between the ages of 10 and 14 years.

The move, anticipated to reduce morbidity and mortality cases of cervical cancer in the country, saw over 880 000 girls being vaccinated.

In Zimbabwe, reproductive cancers for both males and females account for high percentages of morbidity and mortality as compared to other cancers, the latest cancer report has revealed.

Cervical cancer is the second most common cancer in women, with 99 percent of the cases associated with HPV infection. The most occurring cancers among Zimbabweans of all races is cervical cancer (18 percent).

Annually, 2 270 new cases of cervical cancer are recorded in Zimbabwe with 1 541 succumbing to the disease. The HPV vaccine is a World Health Organisation (WHO) recommended intervention to prevent infection with two types of HPV known to lead to about 70 percent of cervical cancers.

The Ministry of Health and Child Care’s director for epidemiology and disease control, Dr Portia Manangazira, rebuked the rising incidence of cervical cancer in women.

“High HPV vaccine coverage will reduce the economic and human costs of cervical cancer,” said Dr Manangazira.“The HPV vaccine is a safe and effective vaccine that presents exciting opportunities for public health in the long run. Its benefits are realised years after the young girls have been vaccinated.

“Ideally females should get the vaccine before they become sexually active and exposed to HPV. Females who are sexually active may also benefit from vaccination, but they may get less benefit.”

The vaccination programme, which was held between May 14 and May 18, 2018 in all the country’s districts, is meant to protect girls from cancer of the cervix. Zimbabwe becomes the eighth African country to introduce HPV vaccine into its routine immunisation programme.

HPV is the main cause of cervical cancer and is a common virus that is passed from one person to another during an intercourse.

Every year, 530 000 new cases of cervical cancer are diagnosed globally, with 275 000 lives claimed. Globally, the incidence of cervical cancer is at 15 per 100 000 women and in Zimbabwe, it stands at 35 per 100 000.

The high percentages have been attributed to lack of health seeking behaviours and lack of readily available cancer facilities. Cancer Association of Zimbabwe monitoring and evaluation officer, Mr Lovemore Makurirofa said poor health seeking behaviours are fuelling cancer cases in the country.

“Many people become adamant when it comes to issues regarding their reproductive health and many a times they ignore the early signs of cancers and only visit the hospital when the cancers would’ve been at advanced stages,” he said.

“Cervical cancer is highly preventable and when found early, it is highly treatable and associated with long survival. “For almost all cancers, it takes about 10 years from its progression to Stage One.

“About 81 percent of all cancers recorded in Zimbabwe are diagnosed at advanced stages.”

According to the Zimbabwe National Cancer Registry (2013), which was published in August 2015, among black women, the most frequently occurring cancer is cervical cancer accounting for 32,1 and for black men it is prostate cancer, recording 17,8 percent. The leading cause of deaths was cervical cancer with 13 percent and prostate cancer nine percent.

Early on, cervical cancer may not cause signs and symptoms while advanced cervical cancer may cause bleeding or discharge from the vagina. HPV vaccine for prevention of cervical cancer was piloted by Government in 2014 and 2015 in three districts with great success.

The First Lady Auxilia Mnangagwa officially launched the national HPV vaccination programme roll out in Mutare early this month. The vaccine is administered twice, with the second dose given after six months and not later than two years since the first vaccination.

In Zimbabwe, immunisation of children is met with resistance from some parents who say that their children develop severe adverse effects after getting the shots.

Health experts maintain that it is not uncommon for children to develop a fever after immunisation as this simply means that the vaccine is at work. However, radical symptoms require health practitioner’s attention.

“Since vaccines depend on a functioning immune system to become effective, (sero-conversion), some discomfort may be the body”s way of acknowledging the stimulation in readiness for full protection from the natural infection,” explained Dr Manangazira.

“Most vaccine reactions are usually minor and temporary. While any serious injury or death caused by vaccines is one too many, the benefits of vaccination greatly outweigh the risk, and many more injuries and deaths would occur without vaccines.”

The vaccine was studied in thousands of people around the world, and these studies presented no serious safety concerns. Side effects reported include pain where the shot was given, fever, dizziness and nausea. Costs for diagnosis and treatment of cancers are determined by the type of cancer, position of the cancer, stage of the cancer and the type of treatment it requires.

According to a survey conducted by The Sunday Mail Society, radiotherapy for a whole session costs between US$3 000 and US$4 000 while chemotherapy costs between US$100 and US$41 000 per cycle, depending on the stage at which the cancer is.

The Government and its partners have invested in the HPV vaccine for the good health of women.

“Girls who will have missed the vaccination during the campaign can get vaccinated at clinics until June 18, 2018.” From the year 2019, the national scale-up will be targeting girls in Grade Five (in or out of school).

However, Mr Makurirofa feels that the total number of new cancer cases might be an underestimation as some people are failing to access cancer services.

“Statistics recorded by the Cancer Registry isn’t a true reflection of the new cancer cases because some people aren’t accessing cancer services due to the distance they have to travel and the high costs associated with seeking treatment,” he explained.

Mr Makurirofa encouraged the Government to continue investing in prevention of cancers.“If Government invests in the prevention of cancers by holding awareness campaigns on living healthy and the signs and symptoms of cancers, we will be able to cut down on the cancer treatment burden,” Mr Makurirofa said.

“Decentralisation of cancer services is also a key factor which can assist the country to see a reduction in cancer cases, thereby lifting the burden of expensive cancer treatment amongst the people.”